身体质量指数和血脂对良性前列腺增生患者前列腺体积的影响  

Effects of body mass index and serum lipid levels on prostate volume in patients with benign prostatic hyperplasia

作　　者：逄瑷博 吕俊刚[2] 凌存保[1] 张桐硕 张春燕[1] 田亚平[1] PANG Aibo;LYU Jungang;LING Cunbao;ZHANG Tongshuo;ZHANG Chunyan;TIAN Yaping(Birth Defects Prevention and Control Technology Research Center,Medical Research and Innovation Department,Chinese PLA General Hospital,Beijing 100853;The Third Department of Internal Medicine,Beijing Corps Hospital of Chinese People s Armed Police Force,Beijing 100027;Department of Clinical Laboratory and Pathology,Jiangsu Provincial Corps Hospital of Chinese People s Armed Police Force,Yangzhou 225003,China)

机构地区：[1]中国人民解放军总医院医学创新研究部出生缺陷防控技术研究中心,北京100853 [2]中国人民武装警察部队北京市总队医院内三科,北京100027 [3]中国人民武装警察部队江苏省总队医院检验与病理科,江苏扬州225003

出　　处：《现代泌尿外科杂志》2024年第2期114-118,共5页Journal of Modern Urology

基　　金：国家重点研发计划“主动健康和老龄化科技应对”重点专项项目(No.2021YFC2009300)。

摘　　要：目的探讨良性前列腺增生(BPH)患者身体质量指数(BMI)和血脂水平与前列腺体积的相关性,为临床防治BPH提供参考。方法回顾性分析2014年1月—2022年12月中国人民解放军总医院泌尿外科收治的初次行前列腺穿刺活检术或前列腺切除术且病理明确诊断为BPH的患者578例,收集临床资料包括年龄、病程、BMI、既往病史及生化指标,并根据前列腺总体积(TPV)分级将研究对象划分为TPV>75 mL组和TPV≤75 mL组。比较两组患者的一般资料,用线性回归分析法分析BPH患者TPV的预测因素;进一步对样本按照BMI参考值进行分层,观察不同亚组样本中载脂蛋白B(ApoB)对TPV的影响差异。结果共纳入578例BPH患者,其中TPV>75 mL组215例,TPV≤75 mL组363例,TPV>75 mL组BMI、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、ApoB水平显著高于TPV≤75 mL组(P<0.01)。多因素线性回归分析结果:年龄(β=0.604,P=0.003)、BMI(β=2.000,P<0.001)、ApoB(β=23.792,P<0.001)与TPV具有显著的正线性相关性。调整年龄、BMI混杂因素后,在BMI<24的BPH患者中,ApoB与TPV无线性相关(P>0.05);在超重和肥胖BPH患者中,ApoB可预测TPV增长(β=26.411,P=0.011;β=47.602,P=0.017)。结论年龄、ApoB和BMI或可作为BPH患者前列腺体积增长的预测指标,有利于进一步研究BPH的发病及进展。Objective To explore the correlation between body mass index(BMI)and lipid indexes with prostate volume in patients with benign prostatic hyperplasia(BPH)so as to provide reference for the clinical prevention of this disease.Methods Clinical data of 578 patients admitted to the Department of Urology of Chinese PLA General Hospital during Jan.2014 and Dec.2022 were collected.The patients underwent initial prostate puncture biopsy or prostatectomy and BPH was confirmed pathologically.The patients age,time of onset of the disease,BMI,past medical history and biochemical indexes were analyzed.According to the total prostate volume(TPV)grading,the patients were divided into TPV>75 mL and TPV≤75 mL groups.The general data of the two groups were compared,and predictors of TPV were determined with linear regression analysis.The samples were stratified with BMI to observe the differences in the effects of apolipoprotein B(ApoB)on TPV.Results There were 215 cases in the TPV>75 mL group and 363 cases in the TPV≤75 mL group.The levels of BMI,triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and apolipoprotein B(ApoB)were higher in the TPV>75 mL group(P<0.01).Multivariate linear regression analysis showed that age(β=0.604,P=0.003),BMI(β=2.000,P<0.001),ApoB(β=23.792,P<0.001)and TPV had a significant positive linear correlation;after adjusting for the confounders of age and BMI,ApoB was not linearly correlated with TPV in BPH population with BMI<24(P>0.05),and ApoB predicted prostate volume growth in overweight and obese BPH population respectively(β=26.411,P=0.011;β=47.602,P=0.017).Conclusion Age,ApoB and BMI can be used as predictors of volume growth in BPH patients,which can help further research on the pathogenesis and progression of BPH.

关 键 词：良性前列腺增生 前列腺体积 身体质量指数 载脂蛋白B 

分 类 号：R697.32[医药卫生—泌尿科学]